Measuring women's experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire

Anna Dencker, Liselotte Bergqvist, Marie Berg, Josephine T V Greenbrook, Christina Nilsson, Ingela Lundgren, Anna Dencker, Liselotte Bergqvist, Marie Berg, Josephine T V Greenbrook, Christina Nilsson, Ingela Lundgren

Abstract

Background: Women's experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience. Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2.

Method: A total of 11 new items (Professional Support and Participation) and 14 original items from the first CEQ (Own capacity and Perceived safety), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit.

Results: The hypothesised four-factor model showed good fit (CMIN = 2.79; RMR = 0.33; GFI = 0.94; CFI = 0.94; TLI = 0.93; RMSEA = 0.054 and PCLOSE = 0.12) Cronbach's alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91).

Conclusions: CEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.

Keywords: CEQ; CEQ2; Childbirth experience questionnaire; Maternal satisfaction.

Conflict of interest statement

All authors declare that there are no conflicts of interest, including no financial or personal gains, resulting from publishing this work.

References

    1. Attanasio L, McPherson M, Kozhimannil K. Positive childbirth experiences in US hospitals: a mixed methods analysis. Matern Child Health J. 2014;18(5):1280–1290. doi: 10.1007/s10995-013-1363-1.
    1. Karlström A, Nystedt A, Hildingsson I. The meaning of a very positive birth experience: focus groups discussions with women. BMC Pregnancy Childbirth. 2015;15:251. doi: 10.1186/s12884-015-0683-0.
    1. Fair CD, Morrison TE. The relationship between prenatal control, expectations, experienced control, and birth satisfaction among primiparous women. Midwifery. 2012;28(1):39–44. doi: 10.1016/j.midw.2010.10.013.
    1. Sigurdardottir VL, Gamble J, Gudmundsdottir B, Kristjansdottir H, Sveinsdottir H, Gottfredsdottir H. The predictive role of support in the birth experience: a longitudinal cohort study. Women Birth. 2017;30(6):450–459. doi: 10.1016/j.wombi.2017.04.003.
    1. Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–1134. doi: 10.1017/S0033291715002706.
    1. Elmir R, Schmied V, Wilkes L, Jackson D. Women’s perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs. 2010;66.
    1. Pang MW, Leung TN, Lau TK, Hang Chung TK. Impact of first childbirth on changes in Women’s preference for mode of delivery: follow-up of a longitudinal observational study. Birth. 2008;35(2):121–128. doi: 10.1111/j.1523-536X.2008.00225.x.
    1. Ross-Davie M, Cheyne H. Intrapartum support: what do women want? A literature review. Evidence Based Midwifery. 2014;12(2):52–58.
    1. Larkin P, Begley CM, Devane D. 'Not enough people to look after you': an exploration of women's experiences of childbirth in the Republic of Ireland. Midwifery. 2012;28(1):98–105. doi: 10.1016/j.midw.2010.11.007.
    1. Dencker A, Nilsson C, Begley C, Jangsten E, Mollberg M, Patel H, Wigert H, Hessman E, Sjoblom H, Sparud-Lundin C. Causes and outcomes in studies of fear of childbirth: a systematic review. Women Birth. 2019;32(2):99–111. doi: 10.1016/j.wombi.2018.07.004.
    1. Moller L, Josefsson A, Lilliecreutz C, Gunnervik C, Bladh M, Sydsjo G. Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: a historical cohort. Acta Obstet Gynecol Scand. 2019;98(3):374–381. doi: 10.1111/aogs.13503.
    1. Hollander MH, van Hastenberg E, van Dillen J, van Pampus MG, de Miranda E, Stramrood CAI. Preventing traumatic childbirth experiences: 2192 women's perceptions and views. Archives Women's Mental Health. 2017;20(4):515–523. doi: 10.1007/s00737-017-0729-6.
    1. Bell AF, Andersson E. The birth experience and women's postnatal depression: a systematic review. Midwifery. 2016;39:112–123. doi: 10.1016/j.midw.2016.04.014.
    1. Quinn K, Spiby H, Slade P. A longitudinal study exploring the role of adult attachment in relation to perceptions of pain in labour, childbirth memory and acute traumatic stress responses. J Reprod Infant Psychol. 2015;33(3):256–267. doi: 10.1080/02646838.2015.1030733.
    1. Berg M, Asta Olafsdottir O, Lundgren I. A midwifery model of woman-centred childbirth care--in Swedish and Icelandic settings. Sexual Reprod Healthc. 2012;3(2):79–87. doi: 10.1016/j.srhc.2012.03.001.
    1. Cornally P, Butler M, Murphy M, Rath A, Canty G. Exploring women's experiences of care in labour. Evidence Based Midwifery. 2014;12(3):89–94.
    1. Nilver H, Begley C, Berg M. Measuring women's childbirth experiences: a systematic review for identification and analysis of validated instruments. BMC Pregnancy Childbirth. 2017;17(1):203. doi: 10.1186/s12884-017-1356-y.
    1. Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth. 2010;10(81).
    1. Walker KF, Wilson P, Bugg GJ, Dencker A, Thornton JG. Childbirth experience questionnaire: validating its use in the United Kingdom. BMC Pregnancy Childbirth. 2015;15(1):86. doi: 10.1186/s12884-015-0513-4.
    1. Soriano-Vidal FJ, Oliver-Roig A, Cabrero-Garcia J, Congost-Maestre N, Dencker A, Richart-Martinez M. The Spanish version of the Childbirth Experience Questionnaire (CEQ-E): reliability and validity assessment.(Report). BMC Pregnancy Childbirth. 2016;16(1).
    1. Abbaspoor Z, Moghaddam-Banaem L, Ronaghi S, Dencker A. Translation and cultural adaptation of the childbirth experience questionnaire (CEQ) in Iran. Iran J Nurs Midwifery Res. 2019;24(4):296–300.
    1. Zhu X, Wang Y, Zhou H, Qiu L, Pang R. Adaptation of the childbirth experience questionnaire (CEQ) in China: a multisite cross-sectional study. PLoS One. 2019;14(4):e0215373. doi: 10.1371/journal.pone.0215373.
    1. Patabendige M. Childbirth experience questionnaire (CEQ): research proposal for translation and validation into Sinhala language among a Lankan cohort of women. BMC Res Notes. 2019;12(1):458. doi: 10.1186/s13104-019-4499-2.
    1. Lathrop A, Bonsack CF, Haas DM. Women's experiences with water birth: a matched groups prospective study. Birth. 2018;45(4):416–423. doi: 10.1111/birt.12362.
    1. King L, McKenzie-McHarg K, Horsch A. Testing a cognitive model to predict posttraumatic stress disorder following childbirth. BMC Pregnancy Childbirth. 2017;17(1):32. doi: 10.1186/s12884-016-1194-3.
    1. Ternström E, Hildingsson I, Haines H, Karlström A, Sundin Ö, Ekdahl J, Segeblad B, Larsson B, Rondung E, Rubertsson C. A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – a study protocol. Sexual Reprod Healthc. 2017;13:75–82. doi: 10.1016/j.srhc.2017.06.001.
    1. Congdon JL, Adler NE, Epel ES, Laraia BA, Bush NR. A prospective investigation of prenatal mood and childbirth perceptions in an ethnically diverse, Low-Income Sample. Birth. 2016;43(2):159–166. doi: 10.1111/birt.12221.
    1. Handelzalts JE, Zacks A, Levy S. The association of birth model with resilience variables and birth experience: home versus hospital birth. Midwifery. 2016;36:80–85. doi: 10.1016/j.midw.2016.03.005.
    1. Toivonen E, Palomaki O, Huhtala H, Uotila J. Maternal experiences of vaginal breech delivery. Birth. 2014;41(4):316–322. doi: 10.1111/birt.12119.
    1. Bergqvist L, Dencker A, Taft C, Lilja H, Ladfors L, Skaring-Thorsén L, Berg M. Women’s experiences after early versus postponed oxytocin treatment of slow progress in first childbirth – a randomized controlled trial. Sexual Reprod Healthc. 2012;3(2):61–65. doi: 10.1016/j.srhc.2012.03.003.
    1. Begley CM, Gross MM, Dencker A, Benstoem C, Berg M, Devane D. Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: a systematic review. Midwifery. 2014;30(9):975–982. doi: 10.1016/j.midw.2014.06.005.
    1. Downe S, Finlayson K, Oladapo OT, Bonet M, Gulmezoglu AM. What matters to women during childbirth: a systematic qualitative review. PLoS One. 2018;13(4):e0194906. doi: 10.1371/journal.pone.0194906.
    1. Walker KF, Dencker A, Thornton JG. Childbirth experience questionnaire 2: validating its use in the United Kingdom. Eur J Obstet Gynecol Reprod Biol X. 2020;5:100097. doi: 10.1016/j.eurox.2019.100097.
    1. Ghanbari-Homayi S, Dencker A, Fardiazar Z, Jafarabadi MA, Mohammad-Alizadeh-Charandabi S, Meedya S, Mohammadi E, Mirghafourvand M. Validation of the Iranian version of the childbirth experience questionnaire 2.0. BMC Pregnancy Childbirth. 2019;19(1):465. doi: 10.1186/s12884-019-2606-y.
    1. Mattison CA, Dion ML, Lavis JN, Hutton EK, Wilson MG. Midwifery and obstetrics: factors influencing mothers' satisfaction with the birth experience. Birth. 2018;45(3):322–327. doi: 10.1111/birt.12352.
    1. Ferguson S, Browne J, Taylor J, Davis D. Sense of coherence and women′s birthing outcomes: A longitudinal survey. Midwifery. 2016;34(Supplement C):158–165. doi: 10.1016/j.midw.2015.11.017.
    1. Mukamurigo JU, Berg M, Ntaganira J, Nyirazinyoye L, Dencker A. Associations between perceptions of care and women's childbirth experience: a population-based cross-sectional study in Rwanda. BMC Pregnancy Childbirth. 2017;17(1):181. doi: 10.1186/s12884-017-1363-z.
    1. Fayers PM, Machin D: Quality of life, assessments, analysis and interpretation, 3 edn: Wiley; 2016.
    1. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7:Cd003766.
    1. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013;7:Cd003766.
    1. Leap N, Hunter B: Supporting women for labour and birth : a thoughtful guide: Abingdon, Oxon. New York, NY : Routledge; 2016.
    1. Bryar RM, Sinclair M: Theory for midwifery practice, 2. ed. edn. Houndmills: Houndmills : Palgrave; 2011.
    1. Nieuwenhuijze MJ, Low LK, Korstjens I, Lagro-Janssen T. The role of maternity care providers in promoting shared decision making regarding birthing positions during the second stage of labor. J Midwifery Women's Health. 2014;59(3):277–285. doi: 10.1111/jmwh.12187.
    1. Lawrence A, Lewis L, Hofmeyr GJ, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. 2013;2013(8):CD003934.
    1. Nieuwenhuijze MJ, Korstjens I, de Jonge A, de Vries R, Lagro-Janssen A. On speaking terms: a Delphi study on shared decision-making in maternity care. BMC Pregnancy Childbirth. 2014;14:223. doi: 10.1186/1471-2393-14-223.
    1. Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, Silva DRAD, Downe S, Kennedy HP, Malata A, et al. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet. 2014;384(9948):1129–1145. doi: 10.1016/S0140-6736(14)60789-3.
    1. Mukamurigo J, Dencker A, Ntaganira J, Berg M. The meaning of a poor childbirth experience - a qualitative phenomenological study with women in Rwanda. PLoS One. 2017;12(12):e0189371. doi: 10.1371/journal.pone.0189371.
    1. Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27. doi: 10.1111/j.0730-7659.2004.0270.x.
    1. Duff E. WHO recommendations in intrapartum care for a positive childbirth experience. Midwifery. 2018;61:A1. doi: 10.1016/j.midw.2018.03.008.

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